Perception and Attitude of Filipinos on Hiring Unlicensed Nurses in the Healthcare System

The issue of inadequate remuneration for nurses is a pressing concern in the Philippines. The Department of Health (DOH) has recently taken steps to address the situation, stating their intention to recruit numerous unlicensed nurses to fulfill vacancies in public hospitals. The department has specified that individuals who have taken the board exam and scored between 70 percent and 74.9 percent but failed to pass it may be granted temporary licenses. This move comes amid an urgent need to fill 4,500 vacant nursing positions across the country.

Capstone-Intel Corporation conducted a nationwide survey to address this pressing issue. This study utilized an online panel data survey methodology, which was conducted from August 1, 2023 to August 10, 2023 and sent to a total of 20,381 data-panel respondents. Out of the total number of respondents, 1,205 completed the survey.

Prior to participating in the survey, the respondents underwent a rigorous screening process to ensure their suitability for the study. The questionnaire was meticulously designed to be completed within a time frame of 15 minutes and consisted of a maximum of three questions.

Capstone-Intel is confident that the survey results offer valuable insights into the opinions surrounding the authorization of unlicensed nursing graduates to operate under supervision. The sample size of 1,205 respondents guarantees an exceptional level of accuracy, with a margin of error of ±3 percent at a 95 percent confidence level. It is essential to note that sub-national estimates for different regions have varying margins of error, ranging from ±6 percent for Metro Manila, balance Luzon, Visayas, and Mindanao.

Capstone-Intel takes immense pride in presenting these findings as an impartial and nonpartisan contribution to the ongoing discourse on permitting unlicensed nursing graduates to work in supervised positions in the Philippines.

There are ongoing discussions about allowing nursing graduates who still need to pass the licensure exam to work in healthcare settings under the supervision of licensed nurses in positions such as “nursing assistants.” This policy is a potential way to address healthcare personnel shortages. Recently, the Department of Health proposed creating a “nursing assistant” position with a Salary Grade of 9 for unlicensed nurses.

However, some are concerned about whether nursing graduates without licenses can provide quality care. Opponents argue that the licensure exam helps ensure that nurses are qualified. There are also concerns about possibly overburdening licensed nurses tasked with supervision.

On the other hand, according to the expert opinion of Dr. Guido David, the esteemed Chief Data Scientist at Capstone-Intel, the recruitment of aspiring nurses in healthcare establishments prior to their licensure examination can significantly enhance their likelihood of successfully clearing the board examination.

“Working in [a] healthcare setting would help improve their chances of passing the board exam,” David said.

This study aims:

1. To know the public’s perception of whether or not unlicensed nursing graduates can help provide quality care,
2. To know the public’s opinion on whether or not this policy could improve their chances of passing the exam,
3. To determine if the public thinks that allowing unlicensed nurses to assist in the healthcare system can help them increase their chances of passing the board exam.

Methodology

This study is a panel-data survey conducted online. The survey was distributed to 20,381 data-panel respondents and 1,205 completed the survey. Respondents from data panel surveys are real internet users who go through quality and reliability checks and are selected through a dynamic sampling method. Panel surveys are used for a quicker turn-around, using up-to-date AI and security technologies without neglecting the rigor of traditional research.

Results of the survey

This section shows the results of the survey. The questions are shown, followed by the table showing the results. The data is presented in percentages and the responses are distributed in the National Capital Region, Balance Luzon, Visayas, and Mindanao. The questions are shown both in English and Filipino languages.

Do you believe nursing graduates who have not taken or passed the board exam can help provide quality healthcare services?

“Q31. Sa tingin mo ba, makatutulong magbigay ng de-kalidad na serbisyo sa pangangalaga ng kalusugan ang mga nakapagtapos na nars na hindi pa nakakuha o nakapasa sa board exam?” 

The survey results indicate that 69 percent of respondents believe that unlicensed nurses can provide quality healthcare services. This perception was consistent across the National Capital Region, Balance Luzon, Visayas, and Mindanao. Only 16 percent perceived that unlicensed graduates could provide quality care, while 15 percent were unsure (Table 1).

In your opinion, should nursing graduates who have not taken or passed the board exam be allowed to work in healthcare settings under the supervision of a licensed nurse?

“Q32. Sa iyong opinyon, dapat ba na bigyan ng pagkakataon na magtrabaho sa healthcare settings sa ilalim ng pangangasiwa ng isang lisensiyadong nars ang mga nakapagtapos na nars na hindi pa nakakuha o nakapasa sa board exam?”

The survey results show that 83 percent of respondents believe that unlicensed nurses should be allowed to work in healthcare settings under the supervision of a licensed nurse. This view was consistent across the National Capital Region, Balance Luzon, Visayas, and Mindanao.

Only 13 percent felt unlicensed graduates should only be allowed to work after passing the board exam. Four percent were still determining whether unlicensed graduates should be given work opportunities.

This data indicates that most Filipinos surveyed support giving unlicensed nursing graduates the chance to work under supervision. This aligns with the earlier finding that most believe unlicensed graduates can provide quality healthcare services.

The minority that opposes allowing unlicensed work may have concerns about patient safety, qualifications without the exam, or implications for the nursing profession. Their perspective highlights potential counterpoints as policymakers evaluate this issue. Overall, the survey reveals that most Filipinos are open to allowing supervised work for unlicensed graduates. However, dissenting views suggest a nuanced debate with reasonable arguments on both sides. These perceptions offer valuable insights as stakeholders determine the best path forward.

In your opinion, would allowing nursing graduates to work under the supervision of licensed nurses as healthcare associates improve their chances of passing the board exam?

“Q33. Sa iyong opinyon, makatutulong ba sa pag-improve ng kanilang pagkakataong pumasa sa board exam kung pahihintulutang magtrabaho ang mga nakapagtapos na nars sa ilalim ng pangangasiwa ng mga lisensiyadong nars bilang healthcare associates?”

 The survey results show that 83 percent of the respondents believe allowing nursing graduates to work as healthcare associates under the supervision of licensed nurses would improve their chances of passing the board exam. More than 80 percent of the respondents across the regions agreed to this proposal.

Only 12 percent felt graduates should instead study in review centers to boost their passing chances rather than be allowed supervised work opportunities.

Five percent were still determining if supervised work would help improve exam outcomes. This aligns with earlier findings – since most Filipinos believe unlicensed graduates can contribute to healthcare delivery, they also feel that on-the-job experience gained under supervision would benefit exam performance.

Overall, these perceptions around supervised work improving the chances of passing the licensure exam further support the openness to allowing unlicensed nursing graduates to take on such roles expressed in earlier survey questions.

Disclaimer: The findings and positions presented in this report related to allowing unlicensed nursing graduates to work in supervised roles are based solely on the survey data. They do not necessarily reflect the official position of the affiliated institutions of the authors, nor do they reflect the position of official government bodies such as the Department of Health, National, and local government units. The perceptions and opinions summarized in this report do not represent an endorsement of any specific policy proposals regarding this issue.

This story: Perception and Attitude of Filipinos on Hiring Unlicensed Nurses in the Healthcare System was originally published on Capstone-Intel Corp.